【摘要】 目的:探讨早期肠内营养在重症急性胰腺炎(SAP)治疗中的有效性。方法:回顾分析本院近5年来收治的71例SAP患者的临床资料,经综合治疗观察患者血清白蛋白、前白蛋白、肿瘤坏死因子-!(TNF-!)、CD4/CD8、IgG、内毒素水平。按营养支持不同分为36例肠内营养组(EN组),35例全胃肠外营养组(TPN组)。结果:EN组治疗后14d患者血清CD4/CD8比值及IgG水平比TPN组有明显升高(P<0.05);EN组治疗后7、14d时TNF-!与治疗前比较明显下降(P<0.05),且与TPN组比较明显减少(P<0.05);EN组治疗后血清前白蛋白水平比治疗前明显增高(P<0.05),且与TPN组比较亦有显著提高(P<0.05)。结论:早期肠内营养对SAP治疗是安全有效的,能提高血清前白蛋白水平水平,改善SAP营养状况,增强肠道黏膜屏障,抑制炎症因子释放,增强患者的免疫功能,改善SAP的预后。更多还原

【Abstract】 Objective To explore the safety and efficacy of early enteral nutrition in the treatment of severe acute pancreatitis(SAP). Methods The data on 71 patients with SAP who received integrate treatments in our hospital during the past 5 years were retrospectively analyzed.Serum album, prealbumin, TNF-α, CD4/CD8 ratio, IgG, and endotoxin levels were measured in all the patients. 71 patients were randomly assigned to receive either enteral nutrition (EN group, n = 36) or total parenteral nutrition(TPN group,n = 35). Results Serum CD4/CD8 ratio and IgG level were significantly higher in EN group than in TPN group 14 days after treatment (P < 0.05). TNF-α level was markedly declined in EN group 7 and 14 days after treatment as compared with the baseline and that in TPN group (P < 0.05 for both comparisons). Serum prealbumin level was notably elevated in EN group as compared to the baseline and that in TPN group (P < 0.05 for both comparisons). Conclusion Early enteral nutrition is safe and effective in the treatment of SAP. It can enhance prealbumin levels, improve patients′ nutritional state, strengthen the gut mucosal barrier function, suppress the release of inflammatory factors, increase immune function, and improve the prognosis of SAP.更多还原